Abstract:

Objective To understand the nutritional status,dietary structure and intake of some micronutrients in oral feeding patients attacked by chronic heart failure,so as to provide scientific bases for guiding their rational diet and formulating relevant nutritional interventions.Methods A total of 106 oral feeding patients with chronic heart failure in Department of Cardiology of a tertiary hospital were investigated. The nutritional status of the patients was evaluated by the Heart Failure specific Mini Nutrition Assessment scale（MNA-HF）,and the breakfast,lunch,supper and extra meals of the patients were recorded by 24-hour diet review. The total amount of dietary nutrients was calculated and compared with the Dietary Guidelines for Chinese Residents（2016）,the Reference Dietary Intake of Chinese Residents（2013） and Jiangsu Dietary Survey Data in 2010 to 2012.Results 106 oral feeding patients with chronic heart failure were investigated by MNA-HF scale,and it was found that the incidence of nutritional risks or malnutrition was about 61.32%. The per capita daily intake of vegetables,soybeans and nuts in patients with heart failure accorded with the recommended values of Dietary Guidelines for Chinese Residents. Cereals,potatoes,beans,fruits,milk and dairy products have not yet reached the recommended values. Livestock and poultry,meat,aquatic products,eggs,oils and fats and salts all exceed the recommended values. The per capita daily intake of energy is about 5 316.66±659.15 kJ;the per capita daily intake of protein,fat and carbohydrates is about 62.27±23.24 g,51.27±37.81 g and 140.28±47.46 g,respectively;the energy supply ratios are about 20.34%,33.42% and 46.15%,respectively. The per capita daily intake of sodium and iron was higher than the recommended intake or appropriate intake（RNIs or AIs）. The per capita daily intake of vitamin B1 and potassium was lower than that of RNIs or AIs.Conclusion The nutritional and dietary status of patients with chronic heart failure who take food by mouth is hardly optimistic. It was suggested that nurses could strengthen nutritional risk screening and dietary guidance for patients suffered with chronic heart failure,and formulate relevant interventions for patients with nutritional risks or malnutrition.

Key words: Chronic Heart Failure, Nutritional Status, Dietary Survey, Nursing Care

摘要：

目的 了解经口进食的慢性心力衰竭患者的营养状态、膳食结构及部分微量营养素摄入状况,为指导其合理膳食及制订相关营养干预措施提供依据。方法 调查在某三级甲等医院心力衰竭中心住院的106例经口进食的慢性心力衰竭患者,通过心力衰竭特异性微型营养评价量表评估患者的营养状况,并采用24 h膳食回顾法记录患者3 d的早、中、晚3餐及加餐情况。计算膳食中的各类营养素含量,与《中国居民膳食指南（2016）》《中国居民膳食营养素参考摄入量（2013）》及2010年—2012年江苏省膳食调查数据进行比较。结果 106例经口进食的慢性心力衰竭患者存在营养风险,营养不良的发生率约61.32%。心力衰竭患者蔬菜类、大豆类及坚果类食物的每日人均摄入量符合中国居民膳食指南推荐要求;谷类薯类及杂豆、水果类、奶类及奶制品尚未达到推荐要求;畜禽肉类、水产类、蛋类、油脂类、盐类均超过推荐要求。每日人均摄入能量为（5 316.66±659.15） kJ,每日人均摄入蛋白质、脂肪、碳水化合物分别为（62.27±23.24） g、（51.27±37.81） g、（140.28±47.46） g,供能比分别为20.34%、33.42%、46.15%。每日人均摄入钠和铁高于推荐摄入量;每日人均摄入维生素B1和钾低于推荐摄入量。结论 经口进食的慢性心力衰竭患者营养及膳食状况不容乐观。护士应加强对慢性心力衰竭患者营养风险的筛查和膳食指导工作,并对存在营养风险或营养不良的患者制订相关干预措施。

关键词: 慢性心力衰竭, 营养状况, 膳食调查, 护理